Academy Award in makeup? Not for these patient gaffs

February 9, 2020
Three common makeup faux pas frequently cause eye health concerns. How doctors and staff can counsel healthy makeup habits in patients.
Awards Ceremony - Red Carpet Entrance - Healthy Makeup Habits

And the Oscar for best makeup goes to—not these patients.

Professional makeup artists most patients are not; celebrities' show-stopping, red-carpet looks are sure to spark some lookalike attempts, but there's a thin margin between striking, smoky eyes and fiery, painful ones. Even routine cosmetic application can aggravate or inflame the eyelids, gunk up the tear film or carelessly cause infection, and doctors of optometry—primary eye care providers—are a critical line of defense against these makeup mishaps.

"Optometrists must be up to date on all of the different makeup options available for their patients, how they work and what the potential side effects and treatments are," says Tamara Petrosyan, O.D., State University of New York College of Optometry associate clinical professor.

"Patients are now able to walk into a beauty parlor or find a DIY kit and get treatments—to name a few—such as false eyelashes attached by glue, magnetic eyeliner or magnetic clips, eyelash extensions and weaves, eyelash perms, eyelash serums and semi-permanent tattoo makeup."

3 common makeup mistakes

But even as alarming as that may sound, those products and treatments still don't account for the most common cause of makeup faux pas that drive patients into clinics. The topic of Dr. Petrosyan's continuing education (CE) course available at Optometry's Meeting® this summer, harmful makeup practices often fall into three categories:

Failing to check ingredients or expiration date.

Over half of makeup users report never checking the instructions regarding how long their makeup should be left on and 9 in 10 women use cosmetics past their expiration date. Both points are cause of concern—especially around the eye—as makeup with a higher water content is more prone to bacterial and fungal buildup and require certain preservatives added that can be an eye irritant, Dr. Petrosyan notes. So, too, makeup may contain ingredients, such as arsenic, beryllium, cadmium, carmine, lead, nickel, selenium and thallium that all can cause allergic reactions or irritation—and that's not to mention what can flake off or accumulate in the tear film. For instance, two-step mascaras consisting of a nylon base coat and colored top coat are prone to flaking and migrating into the tear film.

"All makeup has an expiration time from when it is opened, and it can be found on the back label, marked in months (6M = 6 months after opening)," Dr. Petrosyan tells patients. "Keep a marker in the makeup kit to note the date a product was opened. In general, makeup should be disposed of every three to six months."

Failing to keep makeup applicators clean.

This goes back to the threat of contamination and the harmful ingredients in cosmetics that can cling to unclean applicators or brushes. Of course, patients should never use makeup if they have eye irritation or an infection, and eye makeup used during an eye infection must be thrown out. In the same way, Dr. Petrosyan also advises against patients using the same pencil on different parts of the eyes or face to limit spread of bacteria and never using saliva to assist makeup application.

"Keep makeup applicators clean by washing all brushes properly and using a brush cover when not in use, then replace brushes at least every six to twelve months and if used during an eye infection," Dr. Petrosyan suggests. "Try sharpening your makeup pencil before use to remove the topmost layer of bacteria and do not pump the mascara brush in and out of the container as this introduces air and potentially bacteria into the bottle."

Failing to remove makeup before sleeping.

Makeup must be removed before sleeping to avoid clogging the meibomian glands and to prevent infection, Dr. Petrosyan stresses. Patients should remove their contact lenses before removing makeup as makeup removal solutions can adhere to contact lenses if any small amount gets into the tear film, causing contact lens wear discomfort. Dr. Petrosyan also tells patients to use gel-based makeup removal products that are oil and paraben-free, and avoid those with mineral oil, sodium lauryl sulfate and diazolidinyl urea.

"Using a gentle eyelid scrub after the makeup is removed can help remove excess makeup and the makeup removal solution, as well as help unclog the meibomian glands," she adds.

Typically, patients aren't aware of the anatomy and physiology of their eyelids and meibomian glands, Dr. Petrosyan says, so they often watermark their upper and lower eyelids, i.e., applying eyeliner to the inside of the lash line and coat the openings of the meibomian glands with makeup. In turn, this can create a clogged, dysfunctional meibomian gland.

In fact, a 2015 study traced the migration of eyeliner particles into subjects' tear film in as little as five to 10 minutes post-application. Unsurprisingly, when patients applied eyeliner along the inside of the lash line, researchers observed not only a faster migration time but also 15-30% more particles in the tear film. Although the particles dissipated two hours after application, researchers note that eyeliner residue on contact lenses or in the tear film is a common sight at clinics.

"We need to discuss this with patients as soon as possible because preventing a dysfunction or treating it early on is much more efficient and effective than dealing with a severe case," she says.

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